MEDICARE: NUSRATH HASAN BAIG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	WV16821	WV
2	2084P0800X	Psychiatry Physician	ME106308	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	001711183	OTHER	WV	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205824513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NUSRATH HASAN BAIG MD

Provider Business Mailing Address
First Line	:	PO BOX 690913
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32869-0913
Country	:	US
Telephone Number	:	407-808-5421
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 CENTRAL FLORIDA PARKWAY
Second Line	:	CENTRAL FLORIDA BEHAVIORAL HOSPITAL
City	:	ORLANDO
State	:	FL
Zip	:	32821
Country	:	US
Telephone Number	:	407-808-5421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	09/30/2016

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Directions to “ NUSRATH HASAN BAIG MD” Practice Location

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